Individual
LUISA ELLENBOGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
770 LAKE COOK RD STE 105, DEERFIELD, IL 60015-4920
(866) 220-8371
Mailing address
770 LAKE COOK RD STE 105, DEERFIELD, IL 60015-4920
(866) 220-8371
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.022228
IL
Other
Enumeration date
10/18/2025
Last updated
10/18/2025
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